OB 13,14,15,16,19,20

A woman who is 39 weeks pregnant expresses fear about her impending labor and how she will manage. The nurse's best response is:

It's normal to be anxious about labor. Let's discuss what makes you afraid."

The most critical nursing action in caring for the newborn immediately after birth is:

Keeping the newborn's airway clear.

Muslim countries Will not eat pork or pork products

Korean or other South East Asian countries Prefer not to give babies colostrum

Which fetal heart rate (FHR) finding would concern the nurse during labor?

Late decelerations

With regard to nerve block analgesia and anesthesia, nurses should be aware that:

Most local agents are related chemically to cocaine and end in the suffix -caine.

Rho immune globulin will be ordered postpartum if which situation occurs?

Mother Rh?2-, baby Rh+

When the infant's behaviors and characteristics call forth a corresponding set of maternal behaviors and characteristics, this is called:

Mutuality

A laboring woman received an opioid agonist meperidine intravenously 90 minutes before she gave birth. Which medication should be available to reduce the postnatal effects of Demerol on the neonate?

Naloxone Narcan

It is important for the nurse to develop a realistic birth plan with the pregnant woman in her care. The nurse can explain that a major advantage of nonpharmacologic pain management is:

No side effects or risks to the fetus are involved.

Remaining fairly stable throughout the first and second stages

Duration

When caring for a newly delivered woman, the nurse is aware that the best measure to prevent abdominal distention after a cesarean birth is:

Early and frequent ambulation.

Which deceleration of the fetal heart rate would not require the nurse to change the maternal position?

Early decelerations

What correctly matches the type of deceleration with its likely cause?

Late deceleration—uteroplacental inefficiency

If a woman complains of back labor pain, the nurse could best suggest that she:

Lean over a birth ball with her knees on the floor.

During which phase of maternal adjustment will the mother relinquish the baby of her fantasies and accept the real baby?

Letting go

Which statement correctly describes the effects of various pain factors?

Levels of pain-mitigating Beta-endorphins are higher during a spontaneous, natural childbirth.

Signs that precede labor include

Lightening. Bloody show. Rupture of membranes.

implement a number of care measures to help the client view the childbirth experience in a positive manner. Which intervention would be key for the nurse to use while providing care?

Limiting the number of procedures that invade her body

A means of controlling the birth of the fetal head with a vertex presentation is:

The Ritgen maneuver.

In assisting with the two factors that have an effect on fetal status pushing and positioning , nurses should:

Encourage the woman's cooperation in avoiding the supine position.

The nurse knows that proper placement of the tocotransducer for electronic fetal monitoring is located:

Over the uterine fundus

Which statement regarding PPD is essential for the nurse to be aware of when attempting to formulate a nursing diagnosis?

PPD can easily go undetected.

Which basic type of pelvis includes the correct description and percentage of occurrence in women?

Platypelloid: flattened, wide, shallow; 3%

The nurse can help a father in his transition to parenthood by:

Pointing out that the infant turned at the sound of his voice.

The best way for the nurse to promote and support the maternal-infant bonding process is to:

Assist the family with rooming-in.

To promote bonding and attachment immediately after delivery, the most important nursing intervention is to:

Assist the mother in assuming an en face position with her newborn

Which nursing action is most appropriate to correct a boggy uterus that is displaced above and to the right of the umbilicus?

Assist the patient in emptying her bladder.

Discharge instruction, or teaching the woman what she needs to know to care for herself and her newborn, officially begins:

At the time of admission to the nurse's unit.

When assessing a woman in labor, the nurse is aware that the relationship of the fetal body parts to one another is called fetal:

Attitude is the relation of the fetal body parts to one another

According to standard professional thinking, nurses should auscultate the fetal heart rate (FHR):

Before and after ambulation and rupture of membranes.

When managing the care of a woman in the second stage of labor, the nurse uses various measures to enhance the progress of fetal descent. These measures include:

Encouraging the woman to try various upright positions, including squatting and standing.

one

Engagement

Which action is correct when palpation is used to assess the characteristics and pattern of uterine contractions?

Evaluate the intensity by pressing the fingertips into the uterine fundus.

Increasing the infusion rate of nonadditive intravenous fluids can increase fetal oxygenation primarily by:

Expanding maternal blood volume.

Step 6

Explain findings to the patient.

seven

Expulsion

With regard to parents' early and extended contact with their infant and the relationships built, nurses should be aware that:

Extended contact is especially important for adolescents and low-income women because they are at risk for parenting inadequacies.

five

Extension

six

External rotation

Excessive blood loss after childbirth can have several causes; the most common is:

Failure of the uterine muscle to contract firmly.

Group care activities as much as possible.

Fatigue related to energy expenditure during labor and birth

A nulliparous woman who has just begun the second stage of her labor would most likely:

Feel tired yet relieved that the worst is over.

A woman who is gravida 3 para 2 enters the intrapartum unit. The most important nursing assessments are:

Fetal heart rate, maternal vital signs, and the woman's nearness to birth.

The most common cause of decreased variability in the fetal heart rate FHR that lasts 30 minutes or less is:

Fetal sleep cycles

To care for a laboring woman adequately, the nurse understands that the __________ stage of labor varies the most in length

First

Which description of the four stages of labor is correct for both definition and duration?

First stage: onset of regular uterine contractions to full dilation; less than 1 hour to 20 hours

three

Flexion

If an opioid antagonist is administered to a laboring woman, she should be told that:

Her pain will return.

As a perinatal nurse you realize that a fetal heart rate that is tachycardic, is bradycardic, or has late decelerations or loss of variability is nonreassuring and is associated with:

Hypoxemia.

Chapter 14: 18-year-old pregnant woman, gravida 1, is admitted to the labor and birth unit with moderate contractions every 5 minutes that last 40 seconds. The woman states, "My contractions are so strong that

I don't know what to do with myself." The nurse should Recognize that pain is personalized for each individual

In follow-up appointments or visits with parents and their new baby, it may be useful if the nurse can identify parental behaviors that can either facilitate or inhibit attachment. Which one is a facilitating behavior?

The parents hover around the infant, directing attention to and pointing at the infant.

It is paramount for the obstetric nurse to understand the regulatory procedures and criteria for admitting a woman to the hospital labor unit. Which guideline is an important legal requirement of maternity care?

The patient's weight gain is calculated to determine whether she is at greater risk for cephalopelvic disproportion (CPD) and cesarean birth.

When assessing a multiparous woman who has just given birth to an 8 lb boy, nurse notes that the woman's fundus is firm and has become globular in shape. A gush of dark red blood comes from her vagina. nurse concludes that:

The placenta has separated.

The mother-baby nurse is able to recognize reciprocal attachment behavior. This refers to:

The positive feedback an infant exhibits toward parents during the attachment process.

To help clients manage discomfort and pain during labor, nurses should be aware that:

The predominant pain of the first stage of labor is the visceral pain located in the lower portion of the abdomen.

Fetal well-being during labor is assessed by

The response of the fetal heart rate to uterine contractions

A new client and her partner arrive on the labor, delivery, recovery, and postpartum unit for the birth of their first child. You apply the electronic fetal monitor (EFM) to the woman. Her partner asks you to explain what is printing

on the graph, referring to the EFM strip. He wants to know what the baby's heart rate should be. Your best response is:

A postpartum woman overhears the nurse tell the obstetrics clinician that she has a positive Homans sign and asks what it means. The nurse's best response is:

"You have calf pain when the nurse flexes your foot."

Chap. 13: A new mother asks the nurse when the "soft spot" on her son's head will go away. The nurse's answer is based on the knowledge that the anterior fontanel closes after birth by

18 months

Which collection of risk factors most likely would result in damaging lacerations including episiotomies ?

A first-time mother with reddish hair whose rapid labor was overseen by an obstetrician

In order to care for obstetric patients adequately, the nurse understands that labor contractions facilitate cervical dilation by:

Pulling the cervix over the fetus and amniotic sac.

After an emergency birth, the nurse encourages the woman to breastfeed her newborn. The primary purpose of this activity is to:

Stimulate the uterus to contract

The nurse expects to administer an oxytocic , Pitocin, Methergine to a woman after expulsion of her placenta to:

Stimulate uterine contraction.

Peaking at 40 to 70 mm Hg in the first stage of labor

Strength

Which factors influence cervical dilation

Strong uterine contractions The force of the presenting fetal part against the cervix The pressure applied by the amniotic sac Scarring of the cervix

The class of drugs known as opioid analgesics butorphanol, nalbuphine is not suitable for administration to women with known opioid dependence. The antagonistic activity could precipitate withdrawal

symptoms abstinence syndrome in both mothers and newborns. Signs of opioid/narcotic withdrawal in the mother would include Yawning, runny nose.Chills and hot flashes.Irritability, restlessness

Nursing activities that promote parent-infant attachment are many and varied. One activity that should not be overlooked is management of the environment. While providing routine mother-baby care,

the nurse should ensure that:................. An environment that fosters as much privacy as possible should be created.

A 25-year-old multiparous woman gave birth to an infant boy 1 day ago. Today her husband brings a large container of brown seaweed soup to the hospital. When the nurse enters the room, the husband asks for help with warming

the soup so that his wife can eat it. The nurse's most appropriate response is to ask the woman: "I'll warm the soup in the microwave for you."

A woman gave birth 48 hours ago to a healthy infant girl. She has decided to bottle-feed. During your assessment you notice that both of her breasts are swollen, warm, and tender on palpation. The woman should be advised that

this condition can best be treated by: Applying ice to the breasts for comfort.

A tiered system of categorizing FHR has been recommended by regulatory agencies. Nurses, midwives, and physicians who care for women in labor must have a working knowledge of fetal monitoring standards and

understand the significance of each category. These categories include Category I. Category II. Nonreassuring.

During labor a fetus with an average heart rate of 135 beats/min over a 10-minute period would be considered to have:

A normal baseline heart rate.

The nerve block used in labor that provides anesthesia to the lower vagina and perineum is called:

A pudendal.

The role of the nurse with regard to informed consent is to:

Act as a client advocate and help clarify the procedure and the options

A patient whose cervix is dilated to 5 cm is considered to be in which phase of labor?

Active phase

Nurses can help their clients by keeping them informed about the distinctive stages of labor. What description of the phases of the first stage of labor is accurate?

Active: Moderate, regular contractions; 4- to 7-cm dilation; duration of 3 to 6 hours

Less pain intensity, decreased use of analgesia, fewer instrumental births

Acupuncture

Instruct the patient and partner in the use of specific relaxation techniques.

Acute pain related to contractions

Of the many factors that influence parental responses, nurses should be conscious of negative stereotypes that apply to specific patient populations. Which response could be an inappropriate stereotype of adolescent mothers?

Adolescent mothers have a higher documented incidence of child abuse.

Step 4

After obtaining permission, gently insert the index and middle fingers into the vagina.

A 25-year-old gravida 1 para 1 who had an emergency cesarean birth 3 days ago is scheduled for discharge. As you prepare her for discharge, she begins to cry. Your initial action should be to

Allow her time to express her feelings.

The nurse caring for the laboring woman should understand that early decelerations are caused by:

Altered fetal cerebral blood flow.

Concerning the third stage of labor, nurses should be aware that:

An expectant or active approach to managing this stage of labor reduces the risk of complications.

Orient the patient and family to the labor and birth unit.

Anxiety related to labor and the birthing process

In documenting labor experiences, nurses should know that a uterine contraction is described according to all these characteristics except:

Appearance shape and height

The nurse providing care for the laboring woman comprehends that accelerations with fetal movement:

Are reassuring.

No difference when compared with placebo

Aromatherapy

After they are born, a crying infant may be soothed by being held in a position in which the newborn can hear the mother's heartbeat. This phenomenon is known as:

Biorhythmicity.

As relates to fetal positioning during labor, nurses should be aware that:

Birth is imminent when the presenting part is at +4 to +5 cm below the spine

The nurse caring for the postpartum woman understands that breast engorgement is caused by:

Congestion of veins and lymphatics.

nurse teaches a pregnant woman about the characteristics of true labor contractions. nurse evaluates the woman's understanding of the instructions when she states, "True labor contractions will

Continue and get stronger even if I relax and take a shower."

Perinatal nurses are legally responsible for:

Correctly interpreting fetal heart rate (FHR) patterns, initiating appropriate nursing interventions, and documenting the outcomes

A woman is experiencing back labor and complains of intense pain in her lower back. An effective relief measure would be to use:

Counterpressure against the sacrum.

While developing an intrapartum care plan for the patient in early labor, it is important that the nurse recognize that psychosocial factors may influence a woman's experience of pain. These include

Culture. Anxiety and fear. Previous experiences with pain. Support systems.

two

Descent

Which description of the phases of the second stage of labor is accurate?

Descent phase: Significant increase in contractions, Ferguson reflux activated, average duration varied

Step 5

Determine dilation, presenting part, status of membranes, and characteristics of amniotic fluid.

When assessing a woman in the first stage of labor, the nurse recognizes that the most conclusive sign that uterine contractions are effective would be:

Dilation of the cervix.

The maternity nurse understands that as the uterus contracts during labor, maternal-fetal exchange of oxygen and waste products:

Diminishes as the spiral arteries are compressed.

The nurse who performs vaginal examinations to assess a woman's progress in labor should:

Discuss the findings with the woman and her partner.

For the labor nurse, care of the expectant mother begins with any or all of these situations, with the exception of:

Formulation of the woman's plan of care for labor.

Generally ranging from two to five contractions per 10 minutes of labor

Frequency

You are evaluating the fetal monitor tracing of your client, who is in active labor. Suddenly you see the fetal heart rate (FHR) drop from its baseline of 125 down to 80. You reposition the mother, provide oxygen, increase

IV fluid, and perform a vaginal examination. The cervix has not changed. Five minutes have passed, and the fetal heart rate remains in the 80s. What additional nursing measures should you take?.........................Notify the care provider immediately..

The laboring woman who imagines her body opening to let the baby out is using a mental technique called:

Imagery.

A hospital has a number of different perineal pads available for use. A nurse is observed soaking several of them and writing down what she sees. This activity indicates that the nurse is trying to:

Improve the accuracy of blood loss estimation, which usually is a subjective assessment.

four

Internal rotation

The postpartum woman who continually repeats the story of her labor, delivery, and recovery experience is:

Making the birth experience "real."

Less pain and anxiety during the first stage of labor

Massage

On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. The nurse's first action is to:

Massage the woman's fundus.

Nursing care measures are commonly offered to women in labor. Which nursing measure reflects application of the gate-control theory?

Massaging the woman's back

Which statement is the best rationale for assessing maternal vital signs between contractions?

Maternal circulating blood volume increases temporarily during contractions.

The nurse caring for the woman in labor should understand that increased variability of the fetal heart rate may be caused by:

Methamphetamines

When implementing care, the nurse would anticipate that a woman from which country would have the father of the baby in attendance?

Mexico

The slight overlapping of cranial bones or shaping of the fetal head during labor is called:

Molding.

A woman in labor has just received an epidural block. The most important nursing intervention is to:

Monitor the maternal blood pressure for possible hypotension

Step 2

Position the woman to prevent supine hypotension.

Postpartal overdistention of the bladder and urinary retention can lead to which complications?

Postpartum hemorrhage and urinary tract

The factors that affect the process of labor and birth, known commonly as the five Ps, include all except

Pressure.

In relation to primary and secondary powers, the maternity nurse comprehends that:

Primary powers are responsible for effacement and dilation of the cervix.

A man calls the nurse's station and states that his wife, who delivered 2 days ago, is happy one minute and crying the next. The man says, "She was never like this before the baby was born." The nurse's initial response could be to:

Reassure him that this behavior is normal.

The nurse thoroughly dries the infant immediately after birth primarily to:

Reduce heat loss from evaporation.

Commonly 45 seconds or more in the second stage of labor

Relaxation time

What three measures should the nurse implement to provide intrauterine resuscitation? Select the response that best indicates the priority of actions that should be taken.

Reposition the mother, increase intravenous (IV) fluid, and provide oxygen via face mask.

The nurse providing newborn stabilization must be aware that the primary side effect of maternal narcotic analgesia in the newborn is:

Respiratory depression.

Average of 10 mm Hg

Resting tone

Continue to provide comfort measures and minimize distractions.

Risk for impaired individual coping

Encourage frequent voiding and catheterize if necessary.

Risk for impaired urinary elimination

The laboratory results for a postpartum woman are as follows: blood type, A; Rh status, positive; rubella titer, 1:8 (EIA 0.8); hematocrit, 30%. How would the nurse best interpret these data?

Rubella vaccine should be given

nurse observes several interactions between a postpartum woman and her new son. What behavior, if exhibited by this woman, would the nurse identify as a possible maladaptive behavior regarding parent-infant attachment?

Seldom makes eye contact with her son

Nurses should be aware of the differences experience can make in labor pain such as:

Sensory pain for nulliparous women often is greater than for multiparous women during early labor.

Chapter 16: The nurse recognizes that a woman is in true labor when she states:

The contractions in my uterus are getting stronger and closer together."

With regard to the turns and other adjustments of the fetus during the birth process, known as the mechanism of labor, nurses should be aware that:

The effects of the forces determining descent are modified by the shape of the woman's pelvis and the size of the fetal head.

In order to evaluate the condition of the patient accurately during labor, the nurse should be aware that:

The endogenous endorphins released during labor will raise the woman's pain threshold and produce sedation.

When using intermittent auscultation (IA) to assess uterine activity, the nurse should be cognizant that

The examiner's hand should be placed over the fundus before, during, and after contractions

Through vaginal examination the nurse determines that a woman is 4 cm dilated, and the external fetal monitor shows uterine contractions every 3.5 to 4 minutes. The nurse would report this as:First stage, active phase.

The first stage, active phase

With regard to factors that affect how the fetus moves through the birth canal, nurses should be aware that:

The normal attitude of the fetus is called general flexion.

Nurses alert to signs of the onset of the second stage of labor can be certain that this stage has begun when:

The nurse is unable to feel the cervix during a vaginal examination.

During a phone follow-up conversation with a woman who is 4 days' postpartum, the woman tells the nurse, "I don't know what's wrong. I love my son, but I feel so let down. I seem to cry for no reason!"

The nurse would recognize that the woman is experiencing:................Postpartum blues

New parents express concern that, because of the mother's emergency cesarean birth under general anesthesia, they did not have the opportunity to hold and bond with their daughter immediately after her birth.

The nurse's response should convey to the parents that:................ Attachment, or bonding, is a process that occurs over time and does not require early contact.

A parent who has a hearing impairment is presented with a number of challenges in parenting. Which nursing approaches are appropriate for working with hearing-impaired new parents

Use devices that transform sound into light. Ascertain whether the patient can read lips before teaching. Written messages aid in communication.

Step 1

Use sterile gloves and soluble gel for lubrication.

The nurse caring for a woman in labor understands that prolonged decelerations:

Usually are isolated events that end spontaneously.

Why is continuous electronic fetal monitoring usually used when oxytocin is administered?

Uteroplacental exchange may be compromised.

The nurse caring for the woman in labor should understand that maternal hypotension can result in:

Uteroplacental insufficiency

The nurse providing care for the laboring woman should understand that late fetal heart rate decelerations are the result of:

Uteroplacental insufficiency.

The nurse providing care for the laboring woman should understand that amnioinfusion is used to treat:

Variable decelerations

In the United States the en face position is preferred immediately after birth. Nurses can facilitate this process by all of these actions except:

Washing both the infant's face and the mother's face.

Significantly decreased use of analgesia, shorter labor

Water immersion

As relates to rubella and Rh issues, nurses should be aware that:

Women should be warned that the rubella vaccination is teratogenic, and that they must avoid pregnancy for 1 month after vaccination.

Reduced length of labor, increased satisfaction of pain relief

Yoga

A primigravida at 39 weeks of gestation is observed for 2 hours in the intrapartum unit. The fetal heart rate has been normal. Contractions are 5 to 9 minutes apart, 20 to 30 seconds in duration, and of mild intensity. Cervical

dilation is 1 to 2 cm and uneffaced (unchanged from admission). Membranes are intact. The nurse should expect the woman to be:Discharged home to await the onset of true labor

A primigravida at 39 weeks of gestation is observed for 2 hours in the intrapartum unit. The fetal heart rate has been normal. Contractions are 5 to 9 minutes apart, 20 to 30 seconds in duration, and of mild intensity. Cervical

dilation is 1 to 2 cm and uneffaced (unchanged from admission). Membranes are intact. The nurse should expect the woman to be:Discharged home to await the onset of true labor.

For women who have a history of sexual abuse, a number of traumatic memories may be triggered during labor. The woman may fight the labor process and react with pain or anger. Alternately, she may become a passive player and

emotionally absent herself from the process The nurse is in a unique position of being able to assist the client to associate the sensations of labor with the process of childbirth and not the past abuse. The nurse can

The baseline fetal heart rate (FHR) is the average rate during a 10-minute segment. Changes in FHR are categorized as periodic or episodic. These patterns include both accelerations and decelerations. The labor nurse is

evaluating the patient's most recent 10-minute segment on the monitor strip and notes a late deceleration. is likely to be caused by which physiologic alteration. Compression of the fetal head Maternal supine hypotension

The nurse notes that a Vietnamese woman does not cuddle or interact with her newborn other than to feed him, change his diapers or soiled clothes, and put him to bed.

evaluating the woman's behavior with her infant, the nurse realizes that:What appears to be a lack of interest in the newborn is in fact the Vietnamese way of demonstrating intense love by attempting to ward off evil spirits.

Women who have participated in childbirth education classes often bring a "birth bag" or "Lamaze bag" with them to the hospital. These items often assist in reducing stress and providing comfort measures. The nurse caring

for women in labor should be aware of common items that a client may bring, including Rolling pin.Tennis balls.Pillow.Stuffed animal or photo.

A woman has requested an epidural for her pain. She is 5 cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the woman's intravenous fluid for a preprocedural bolus. She reviews

her laboratory values and notes that the woman's hemoglobin is 12 g/dL, hematocrit is 38%, platelets are 67,000, and white blood cells (WBCs) are 12,000/mm3. Which factor would contraindicate an epidural for the woman She has thrombocytopenia

Answer: The top line graphs the baby's heart rate. Generally the heart rate is between 110 and 160. The heart rate will fluctuate in response to what is happening during labor."

normal uterine activity pattern in labor is characterized by:Contractions every 2 to 5 minutes.Contractions normally occur every 2 to 5 minutes and last less than 90 seconds with about 30 seconds in between

Chapter: 20..After giving birth to a healthy infant boy, a primiparous woman, 16 years old, is admitted to the postpartum unit. An appropriate nursing diagnosis for her at this time is Risk for impaired parenting related to deficient knowledge

of newborn care. In planning for the woman's discharge, what should the nurse be certain to include in the plan of care? ANSWER Provide time for the patient to bathe her infant after she views an infant bath demonstration

Chapter 15: Fetal bradycardia is most common during:

prolonged umbilical cord compression

A woman in active labor receives an analgesic opioid agonist. Which medication relieves severe, persistent, or recurrent pain; creates a sense of well-being; overcomes inhibitory factors; and may even relax the cervix but

should be used cautiously in women with cardiac disease? Meperidine Demerol

A woman in labor is breathing into a mouthpiece just before the start of her regular contractions. As she inhales, a valve opens, and gas is released. She continues to inhale the gas slowly and deeply until the contraction starts to

subside. When the inhalation stops, the valve closes. This procedure is:An application of nitrous oxide.

Nurses with an understanding of cultural differences regarding likely reactions to pain may be better able to help clients. Nurses should know that _____ women may be stoic until late in labor,

when they may become vocal and request pain relief. Hispanic

Nurses play a critical role in educating parents regarding measures to prevent infant abduction. Which instructions contribute to infant safety and security?......

-The mother should check the photo ID of any person who comes to her room -Parents should use caution when posting photos of their infant on the Internet. -The mom should request that a second staff member verify the identity of any questionable person.

Under the Newborns' and Mothers' Health Protection Act, all health plans are required to allow new mothers and newborns to remain in the hospital for a minimum of

48 hours after a normal vaginal birth and for 96 hours after a cesarean birth.

The uterine contractions of a woman early in the active phase of labor are assessed by an internal uterine pressure catheter (IUPC). The nurse notes that the intrauterine pressure at the peak of the contraction ranges from 65 to

70 mm Hg and the resting tone range is 6 to 10 mm Hg. The uterine contractions occur every 3 to 4 minutes and last an average of 55 to 60 seconds. On the basis of this information, the nurse should:

With regard to spinal and epidural (block) anesthesia, nurses should know that:

A high incidence of after-birth headache is seen with spinal blocks.

When working with parents who have some form of sensory impairment, nurses should understand that Visually impaired mothers cannot overcome the infant's need for eye-to-eye contact. is an inaccurate statement.

A number of electronic devices can turn sound into light flashes to help pick up a child's cry

A laboring woman is lying in the supine position. The most appropriate nursing action at this time is to:

Ask her to turn to one side

When a nulliparous woman telephones the hospital to report that she is in labor, the nurse initially should:

Ask the woman to describe why she believes she is in labor.

A multiparous woman has been in labor for 8 hours. Her membranes have just ruptured. The nurse's initial response would be to:

Assess the fetal heart rate and pattern.

Which occurrence is associated with cervical dilation and effacement?

Bloody show

If a woman is at risk for thrombus and is not ready to ambulate, nurses may intervene by performing a number of interventions. Which intervention should the nurse avoid?

Having the patient sit in a chair.

To assist the woman after delivery of the infant, the nurse knows that the blood patch is used after spinal anesthesia to relieve:

Headache.

Because the risk for childbirth complications may be revealed, nurses should know that the point of maximal intensity (PMI) of the fetal heart tone (FHT) is:

Heard lower and closer to the midline of the mother's abdomen as the fetus descends and rotates internally.

Which method of pain management is safest for a gravida 3 para 2 admitted at 8 cm cervical dilation?

Breathing and relaxation techniques

With regard to breathing techniques during labor, maternity nurses should understand that:

Breathing techniques in the first stage of labor are designed to increase the size of the abdominal cavity to reduce friction.

When assessing the relative advantages and disadvantages of internal and external electronic fetal monitoring, nurses comprehend that both:

Can be used during the antepartum and intrapartum periods.

Which presentation is described accurately in terms of both presenting part and frequency of occurrence?

Cephalic: occiput; at least 95%

To teach patients about the process of labor adequately, the nurse knows that which event is the best indicator of true labor?

Cervical dilation and effacement

The nurse caring for a laboring woman is aware that maternal cardiac output can be increased by:

Change in position.

The nurse hears a primiparous woman talking to her son and telling him that his chin is just like his dad's chin. This woman's statement reflects:

Claiming................ refers to the process by which the child is identified in terms of likeness to other family members

Step 3

Cleanse the perineum and vulva if necessary.

Step 7

Document findings and report to the provider.

With regard to systemic analgesics administered during labor, nurses should be aware that:

Effects on the fetus and newborn can include decreased alertness and delayed sucking.

Maternity nurses often have to answer questions about the many, sometimes unusual ways people have tried to make the birthing experience more comfortable. For instance, nurses should be aware that:

Electrodes attached to either side of the spine to provide high-intensity electrical impulses facilitate the release of endorphins.

What is an essential part of nursing care for the laboring woman?

Helping the woman manage the pain

While providing care to a patient in active labor, the nurse should instruct the woman that:

Frequent changes in position will help relieve her fatigue and increase her comfort.

Leopold maneuvers would be an inappropriate method of assessment to determine:

Gender of the fetus.

Many first-time parents do not plan on their parents' help immediately after the newborn arrives. What statement by the nurse is the most appropriate when counseling new parents about the involvement of grandparents?

Grandparents can help you with parenting skills and also help preserve family traditions."

Which breastfeeding patient is most likely to have severe afterbirth pains and request a narcotic analgesic?

Gravida 5, para 5

Chinese Have an IUD inserted after the first child

Haitian take the placenta home to bury

On observing a woman on her first postpartum day sitting in bed while her newborn lies awake in the bassinet, the nurse should:

Hand the baby to the woman.

A recently delivered mother and her baby are at the clinic for a 6-week postpartum checkup. The nurse should be concerned that psychosocial outcomes are not being met if the woman:

Has not given the baby a name.

In the recovery room, if a woman is asked either to raise her legs off the bed or to flex her knees, place her feet flat on the bed, and raise her buttocks well off the bed, most likely she is being tested to see whether she:

Has recovered from epidural or spinal anesthesia.

In assessing a woman for pain and discomfort management during labor, a nurse most likely would:

Have the woman use a visual analog scale (VAS) to determine her level of pain.

In the current practice of childbirth preparation, emphasis is placed on

Having expectant parents attend childbirth preparation in any or no specific method.

During the taking-hold phase the mother assumes responsibility for her own care and shifts her attention to the infant

In the taking-in phase the mother is primarily focused on her own needs.

A new father states, "I know nothing about babies," but he seems to be interested in learning. This is an ideal opportunity for the nurse to:

Include him in teaching sessions.

A pregnant woman is in her third trimester. She asks the nurse to explain how she can tell true labor from false labor. The nurse would explain that "true" labor contractions:

Increase with activity such as ambulation.

The nurse would expect which maternal cardiovascular finding during labor?

Increased cardiac output

Which concerns about parenthood are often expressed by visually impaired mothers

Infant safety Transportation Missing out visually Needing extra time for parenting activities to

Other early sensual contacts between infant and mother involve sound and smell. Nurses should be aware that, despite what folk wisdom may say:

Infants can learn to distinguish their mother's voice from others soon after birth.

Because a full bladder prevents the uterus from contracting normally, nurses intervene to help the woman empty her bladder spontaneously as soon as possible. If all else fails, the last thing the nurse could try is:

Inserting a sterile catheter.

Late decelerations are almost always caused by uteroplacental insufficiency.

Insufficiency is caused by uterine tachysystole, maternal hypotension, epidural or spinal anesthesia, IUGR, intraamniotic infection, or placental abruption.

When planning care for a laboring woman whose membranes have ruptured, the nurse recognizes that the woman's risk for

Intrauterine infection has increased

In many hospitals new mothers are routinely presented with gift bags containing samples of infant formula. This practice:

Is inconsistent with the Baby Friendly Hospital Initiative.Infant formula should not be given to mothers who are breastfeeding.

Nursing care in the fourth trimester includes an important intervention sometimes referred to as taking the time to mother the mother. Specifically this expression refers to:

Nurturing the woman by providing encouragement and support as she takes on the many tasks of motherhood.

What is an expected characteristic of amniotic fluid?

Pale, straw color with small white particles

With regard to the adaptation of other family members, mainly siblings and grandparents, to the newborn, nurses should be aware that:

Participation in preparation classes helps both siblings and grandparents.

Maternal hypotension is a potential side effect of regional anesthesia and analgesia. What nursing interventions could you use to raise the client's blood pressure

Place the woman in a lateral position. Increase intravenous (IV) fluids. Administer oxygen.

With regard to a pregnant woman's anxiety and pain experience, nurses should be aware that:

Severe anxiety increases tension, which increases pain, which in turn increases fear and anxiety, and so on.

The nurse observes that a 15-year-old mother seems to ignore her newborn. A strategy that the nurse can use to facilitate mother-infant attachment in this mother is to:

Show the mother how the infant initiates interaction and pays attention to her.

A nurse is observing a family. The mother is holding the baby she delivered less than 24 hours ago. Her husband is watching his wife and asking questions about newborn care.

The 4-year-old brother is punching his mother on the back. The nurse should:............ Realize that this is a normal family adjusting to family change.

In a variation of rooming-in, called couplet care, the mother and infant share a room, and the mother shares the care of the infant with:

The Nurse

The nurse has received report regarding her patient in labor. The woman's last vaginal examination was recorded as 3 cm, 30%, and ?2-2. The nurse's interpretation of this assessment is that:

The cervix is 3 cm dilated, it is effaced 30%, and the presenting part is 2 cm above the ischial spines.

Chapter 19: A 25-year-old gravida 2, para 2-0-0-2 gave birth 4 hours ago to a 9-pound, 7-ounce boy after augmentation of labor with Pitocin. She puts on her call light and asks for her nurse right away, stating, "I'm bleeding a lot."

The most likely cause of postpartum hemorrhage in this woman is:............. Uterine atony.

The nurse should be aware that an effective plan to achieve adequate pain relief without maternal risk is most effective if

The mother and family's priorities and preferences are incorporated into the plan.

Document the findings because they reflect the expected contraction pattern for the active phase of labor.

The nurse is responsible for monitoring the uterine contractions to ascertain whether they are powerful and frequent enough to accomplish the work of expelling the fetus and the placenta.

What is an advantage of external electronic fetal monitoring?

The tocotransducer is especially valuable for measuring uterine activity during the first stage of labor.

With regard to a woman's intake and output during labor, nurses should be aware that:

The tradition of restricting the laboring woman to clear liquids and ice chips is being challenged because regional anesthesia is used more often than general anesthesia.

Which nursing assessment indicates that a woman who is in second-stage labor is almost ready to give birth?

The vulva bulges and encircles the fetal head.

The nurse knows that the second stage of labor, the descent phase, has begun when:

The woman experiences a strong urge to bear down.

A primiparous woman is to be discharged from the hospital tomorrow with her infant girl. Which behavior indicates a need for further intervention by the nurse before the woman can be discharged?

The woman leaves the infant on her bed while she takes a shower.

The three tiered system of FHR tracings include Category I, II, and III. Category I is a normal tracing requiring no action. Category II FHR tracings are indeterminate.

This category includes tracings that do not meet Category I or III criteria. Category III tracings are abnormal and require immediate intervention.

A nurse may be called on to stimulate the fetal scalp:

To elicit an acceleration in the fetal heart rate (FHR).

The primary difference between the labor of a nullipara and that of a multipara is the:

Total duration of labor.

When using intermittent auscultation (IA) for fetal heart rate, nurses should be aware that:

Ultrasound can be used to find the fetal heartbeat and reassure the mother if initial difficulty was a factor.

The nurse providing care for the laboring woman realizes that variable fetal heart rate decelerations are caused by:

Umbilical cord compression.

Which maternal condition is considered a contraindication for the application of internal monitoring devices?

Unruptured membranes

At 1 minute after birth, the nurse assesses the newborn to assign an Apgar score. The apical heart rate is 110 bpm, and the infant is crying vigorously with the limbs flexed. The infant's trunk is pink, but the hands and feet are blue.

What is the correct Apgar score for this infant? The Apgar score is 9 because 1 point is deducted from the total score of 10 for the infant's blue hands and feet.

When assessing the fetus using Leopold maneuvers, the nurse feels a round, firm, movable fetal part in the fundal portion of the uterus and a long, smooth surface in the mother's right side close to midline.

What is the likely position of the fetus? RSA

Under which circumstance would it be unnecessary for the nurse to perform a vaginal examination?

When accelerations of the fetal heart rate (FHR) are noted

A first-time mother is concerned about the type of medications she will receive during labor. She is in a fair amount of pain and is nauseous. In addition, she appears to be very anxious.

You explain that opioid analgesics often are used with sedatives because:Sedatives help the opioid work better, and they also will assist you to relax and relieve your nausea."

While evaluating an external monitor tracing of a woman in active labor, the nurse notes that the fetal heart rate for five sequential contractions begins to decelerate late in the contraction, with the nadir of the decelerations occurring

after the peak of the contraction. The nurse's first priority is to:.................... Change the woman's position.

While evaluating an external monitor tracing of a woman in active labor whose labor is being induced, the nurse notes that the fetal heart rate (FHR) begins to decelerate at the onset of several contractions

and returns to baseline before each contraction ends.................. The nurse should Document the finding in the client's record

A woman in the active phase of the first stage of labor is using a shallow pattern of breathing, which is about twice the normal adult breathing rate. She starts to complain about feeling lightheaded

and states that her fingers are tingling. The nurse should:Help her breathe into a paper bag

woman gave birth vaginally to a 9-pound, 12-ounce girl yesterday. Her primary health care provider has written orders for perineal ice packs, use of a sitz bath tid, and a stool softener. What information is most closely

correlated with these orders? The woman has an episiotomy.

The obstetric nurse is preparing the patient for an emergency cesarean birth, with no time to administer spinal anesthesia. The nurse is aware and prepared for the

greatest risk of administering general anesthesia to the patient. This risk is: Aspiration of stomach contents.

After change-of-shift report the nurse assumes care of a multiparous client in labor. The woman is complaining of pain that radiates to her abdominal wall, lower back, and buttocks and down her thighs. Before implementing a

plan of care, the nurse should understand that this type of pain is: Referred.